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November 2018

Correlation of Central Retinal Thickness and Visual Acuity in Diabetic Macular Edema

Author Affiliations
  • 1Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
  • 2Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
JAMA Ophthalmol. 2018;136(11):1215-1216. doi:10.1001/jamaophthalmol.2018.3848

Measurement of central subfield thickness (CST) has traditionally been used in determining the necessity of anti–vascular endothelial growth factor (VEGF) or corticosteroid reinjections for diseases including diabetic macular edema (DME), macular edema from retinal vein occlusions, and choroidal neovascularization in age-related macular degeneration. For example, the DRCR.net (ie, Diabetic Retinopathy Clinical Research Network) algorithm for treating DME uses changes in CST as an indication for retreatment.1 Despite this, the US Food and Drug Administration has not used CST as a surrogate end point for central visual acuity (VA) concerning drug approvals. Central subfield thickness does correlate with baseline VA and to a lesser extent with VA outcome after a period of treatment, but correlations have been surprisingly low, usually in the range of 0.2 to 0.3.2-4 These results, with significant P values despite low correlations of the 2 parameters, indicate great certainty about a weak association.

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